Practice Management

Encouraging patients to take charge of their health care

QOur practice is searching for ways to expand our patient-education efforts, promote healthier lifestyles, and emphasize prevention. We already have an extensive library of handouts we send home with patients. What else can we do?

A The first step is simple: Spend a few extra minutes with each patient, reviewing his chart and making suggestions for a healthier lifestyle. In addition, make patient education more palatable and convenient. If possible, set aside a small office for this purpose. There, you or a nurse can meet with patients to review instructions and answer questions. Install a video monitor and computer in the room so patients can watch educational videos or use interactive software.

You can take this a step further by creating a lending library of books, videos, and CD-ROMs produced specifically for patients. Mo-tivated patients will appreciate the convenience, and unmotivated patients can be sent home with reinforcements.

Finally, refer patients to support groups when appropriate. In addition to tending to patients' emotional needs, these groups can be an excellent source of information, which may reduce the number of calls you get.

When to purge inactive charts from your files

QWhen my partners and I took over a pediatric practice five years ago, we inherited a lot of old patient charts. Some date back 20 years and are for patients we've never seen. Do we have to retain these records? If so, for how long?

A Each state has a different statute of limitations, and the clock doesn't start ticking until a pediatric patient reaches the age of majority—usually 18. So you may need to examine all of these charts to determine which patients fall within this time frame.

Consult your liability carrier or your state or specialty medical society for advice.

Can a university doctor offer professional courtesy?

QYour department's experts have said that it's fine to waive office fees for employees and still charge their health plans for lab work. The state-owned university clinic I work for would like to offer this perk to employees and residents. Would doing so violate federal or state regulations?

AThese rules vary by state and health plan. You need to consult with your hospital's legal and human resources departments for the answers.

Pay for a longtime partner who's looking to slow down

QOne of the nine FPs in our group wants to stop taking night and weekend call. Because he's been with the group for more than 20 years, the rest of us are willing to grant his request. In return for not taking call, he has agreed to a reduced salary. How should we calculate an appropriate pay cut for him?

A It depends on how you normally compensate partners for on-call services. If call coverage is part of the regular salary package, for instance, calculate a per-hour wage for this physician, including time spent on call coverage. Then deduct the amount of time he would have devoted to call coverage and distribute that amount accordingly to the doctors who pick up the slack.

Edited by Kristie Perry,
Contributing Writer

Do you have a practice management question that may be stumping other doctors, too? Write: PMQA Editor, Medical Economics magazine, 5 Paragon Drive, Montvale, NJ 07645-1742, or send an e-mail to mepractice@medec.com (please include your regular postal address). Sorry, but we're not able to answer readers individually.

Kristie Perry. Practice Management.

Medical Economics

2002;6:101.